Book
Countertransference and Related Subjects: Selected Papers
Countertransference and Related Subjects (New York: International Universities Press, 1979; paperback 1999) is the second collection of Harold F. Searles's papers, following his Collected Papers on Schizophrenia and Related Subjects (1965). Its twenty-four chapters, with an introduction, come from his later career. Most concern the intensive psychoanalytic psychotherapy of schizophrenic and borderline patients, and the analyst's own emotional participation in that work. Searles treats the analyst's feelings, including guilt, hope, dedication and the urge to heal, as clinical evidence about the patient and the relationship rather than as interference to be eliminated. Several papers trace the phases of treatment from autism and pathological symbiosis, through ambivalent symbiosis, to a therapeutic symbiosis from which individuation can develop. Others take up delusional transference and the patient's realistic perceptions of the analyst; identity formation and dual or multiple identity in borderline functioning; paranoid processes within a hospital treatment team; violence in schizophrenia; and transitional phenomena. The volume also includes the long paper "The Patient as Therapist to His Analyst". Searles argues there that every person has a therapeutic striving toward others, that psychological illness is bound up with the frustration of that striving, and that the analyst must allow the patient to help them. Book reviews, discussions and an essay on unconscious processes in the environmental crisis widen the range. Library Journal praised its plain, jargon-free prose and vivid clinical portraits, and its sense of the humanity patients share with their therapists.
Main ideas
- The analyst's countertransference feelings, such as guilt, hope, dedication and the wish to heal, are a primary source of information about the patient and the relationship, not mere interference.
- Intensive treatment of schizophrenic patients moves through phases: from autism and pathological symbiosis, through ambivalent symbiosis, to a therapeutic symbiosis between patient and therapist that makes individuation possible.
- Every person has a therapeutic striving toward others; psychological illness is bound up with its frustration, so the analyst must let the patient function as therapist to them.
- Delusional transference rests in part on the patient's realistic perceptions of the analyst, which the analyst needs to recognise.
- Identity is a developmental achievement; borderline ego functioning shows dual and multiple identity processes that the treatment relationship can help integrate.
- Unconscious processes extend beyond the consulting room, to the dynamics of a hospital treatment team and to collective responses to the environmental crisis.
What it shows
- 1975
Harold Searles introduced Patient as therapist to the analyst
Set out in the 1975 paper 'The Patient as Therapist to His Analyst', reprinted in Countertransference and Related Subjects (1979). It holds that an innate psychotherapeutic striving, first aimed at the parents, is among the strongest human strivings, and that the patient seeks to heal the analyst.
Harold Searles introduced Therapeutic symbiosis
Searles described therapeutic symbiosis as a phase of mutual, deeply regressed dependency between patient and therapist. It comes after the patient's early pathological symbiosis and an out-of-contact phase, and before individuation. He placed it at the heart of the deepest therapeutic work.
Harold Searles developed Countertransference
Searles treated the analyst's own feelings, including love, hate and confusion, as central information about the patient and about the relationship. His selected papers on the subject appeared as Countertransference and Related Subjects (1979).
Gallery
Cover of the 1999 paperback of Countertransference and Related Subjects by Harold F. Searles, International Universities Press